Total Knee Arthroplasty: What to Expect? A Survey of the Members of the Dutch Knee Society on Long-Term Recovery after Total Knee Arthroplasty

Abstract

The rate of satisfaction after total knee arthroplasty (TKA) is consistently reported around 80%, leaving one in five patients unsatisfied to some extent. Fulfillment of expectations is reported as the strongest predictor of treatment satisfaction. In this study, we aimed to evaluate what Dutch orthopedic surgeons assume are realistic expectations for recovery 1 year after TKA. We invited the members of the Dutch Knee Society (DKS) to fill out a web-based questionnaire. For expectation measurement, the validated Dutch version of the Hospital for Special Surgery (HSS) knee replacement expectations survey was used. A total of 150 invitations were successfully sent; 84 orthopedic surgeons responded (56%). The overall HSS knee replacement expectation score was 66.0 (standard deviation, 14.0) on a 0 to 100 scale. Most improvement was predicted for the items “pain relief” and “walking short distances.” Expectations related to patients' ability to kneel or squat after TKA were scored poorly. To the opinion of the members of the DKS, after TKA improvement can be expected in domains of pain, function, activities, and psychological wellbeing. Return to normal is not likely to occur, especially in demanding physical activities.

Keywords

total knee arthroplasty - expectations - outcome

• References

• 1 Dutch Arthroplasty Register (LROI). Annual report 2014: Arthroplasty in the picture. Available at: http://www.lroi.nl/en/annual-reports . Accessed November 16, 2016
• 2 Räsänen P, Paavolainen P, Sintonen H. , et al. Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs. Acta Orthop 2007; 78 (01) 108-115
• 3 Dunbar MJ, Richardson G, Robertsson O. I can't get no satisfaction after my total knee replacement: rhymes and reasons. Bone Joint J 2013; 95-B (11) , suppl A ): 148-152
• 4 Dobson F, Hinman RS, Roos EM. , et al. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis Cartilage 2013; 21 (08) 1042-1052
• 5 Tolk JJ, Koot HW, Janssen RP. Computer navigated versus conventional total knee arthroplasty. J Knee Surg 2012; 25 (04) 347-352
• 6 Hamilton DF, Lane JV, Gaston P. , et al. What determines patient satisfaction with surgery? A prospective cohort study of 4709 patients following total joint replacement. BMJ Open 2013; 3 (04) 1-8
• 7 Nilsdotter AK, Toksvig-Larsen S, Roos EM. Knee arthroplasty: are patients' expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up. Acta Orthop 2009; 80 (01) 55-61
• 8 Noble PC, Conditt MA, Cook KF, Mathis KB. The John Insall Award: patient expectations affect satisfaction with total knee arthroplasty. Clin Orthop Relat Res 2006; 452 (452) 35-43
• 9 Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KDJ. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?. Clin Orthop Relat Res 2010; 468 (01) 57-63
• 10 Mancuso CA, Graziano S, Briskie LM. , et al. Randomized trials to modify patients' preoperative expectations of hip and knee arthroplasties. Clin Orthop Relat Res 2008; 466 (02) 424-431
• 11 Mondloch MV, Cole DC, Frank JW. Does how you do depend on how you think you'll do? A systematic review of the evidence for a relation between patients' recovery expectations and health outcomes. CMAJ 2001; 165 (02) 174-179
• 12 Dutch Orthopaedic Association. Guideline total knee arthroplasty. 2014 . Available at: http://richtlijnendatabase.nl/richtlijn/totale_knieprothese/totale_knieprothese_korte_beschrijving.html . Accessed November 16, 2016
• 13 Ghomrawi HMK, Mancuso CA, Westrich GH, Marx RG, Mushlin AI. ; Expectations Discordance Study Group Discordance in TKA expectations between patients and surgeons. Clin Orthop Relat Res 2013; 471 (01) 175-180
• 14 Draugalis JR, Coons SJ, Plaza CM. Best practices for survey research reports: a synopsis for authors and reviewers. Am J Pharm Educ 2008; 72 (01) 11
• 15 van den Akker-Scheek I, van Raay JJ, Reininga IH, Bulstra SK, Zijlstra W, Stevens M. Reliability and concurrent validity of the Dutch hip and knee replacement expectations surveys. BMC Musculoskelet Disord 2010; 11 (01) 242
• 16 Mancuso CA, Sculco TP, Wickiewicz TL. , et al. Patients' expectations of knee surgery. J Bone Joint Surg Am 2001; 83-A [phone]
• 17 Kravitz RL. Patients' expectations for medical care: an expanded formulation based on review of the literature. Med Care Res Rev 1996; 53 (01) 3-27
• 18 Crow R, Gage H, Hampson S, Hart J, Kimber A, Thomas H. The role of expectancies in the placebo effect and their use in the delivery of health care: a systematic review. Health Technol Assess 1999; 3 (03) 1-96
• 19 Zywiel MG, Mahomed A, Gandhi R, Perruccio AV, Mahomed NN. Measuring expectations in orthopaedic surgery: a systematic review. Clin Orthop Relat Res 2013; 471 (11) 3446-3456
• 20 Macario A, Schilling P, Rubio R, Bhalla A, Goodman S. What questions do patients undergoing lower extremity joint replacement surgery have?. BMC Health Serv Res 2003; 3 (01) 11
• 21 Browne JP, Bastaki H, Dawson J. What is the optimal time point to assess patient-reported recovery after hip and knee replacement? A systematic review and analysis of routinely reported outcome data from the English patient-reported outcome measures programme. Health Qual Life Outcomes 2013; 11: 128
• 22 Noble PC, Fuller-Lafreniere S, Meftah M, Dwyer MK. Challenges in outcome measurement: discrepancies between patient and provider definitions of success. Clin Orthop Relat Res 2013; 471 (11) 3437-3445
• 23 Husain A, Lee GC. Establishing realistic patient expectations following total knee arthroplasty. J Am Acad Orthop Surg 2015; 23 (12) 707-713
• 24 Mannion AF, Kämpfen S, Munzinger U, Kramers-de Quervain I. The role of patient expectations in predicting outcome after total knee arthroplasty. Arthritis Res Ther 2009; 11 (05) R139
• 25 Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open 2012; 2 (01) e000435
• 26 Abbasi-Bafghi H, Fallah-Yakhdani HR, Meijer OG. , et al. The effects of knee arthroplasty on walking speed: a meta-analysis. BMC Musculoskelet Disord 2012; 13 (01) 66
• 27 Mizner RL, Petterson SC, Clements KE, Zeni Jr JA, Irrgang JJ, Snyder-Mackler L. Measuring functional improvement after total knee arthroplasty requires both performance-based and patient-report assessments: a longitudinal analysis of outcomes. J Arthroplasty 2011; 26 (05) 728-737
• 28 Weiss JM, Noble PC, Conditt MA. , et al. What functional activities are important to patients with knee replacements?. Clin Orthop Relat Res 2002; (404) 172-188
• 29 Hepinstall MS, Ranawat AS, Ranawat CS. High-flexion total knee replacement: functional outcome at one year. HSS J 2010; 6 (02) 138-144
• 30 Palmer SH, Servant CT, Maguire J, Parish EN, Cross MJ. Ability to kneel after total knee replacement. J Bone Joint Surg Br 2002; 84 (02) 220-222
• 31 Klit J, Jacobsen S, Rosenlund S, Sonne-Holm S, Troelsen A. Total knee arthroplasty in younger patients evaluated by alternative outcome measures. J Arthroplasty 2014; 29 (05) 912-917
• 32 Nunley RM, Nam D, Bashyal RK. , et al. The impact of total joint arthroplasty on sexual function in young, active patients. J Arthroplasty 2015; 30 (02) 335-340
• 33 Dahm DL, Jacofsky D, Lewallen DG. Surgeons rarely discuss sexual activity with patients after THA: a survey of members of the American Association of Hip and Knee Surgeons. Clin Orthop Relat Res 2004; 428 (428) 237-240
• 34 Neuprez A, Delcour J-P, Fatemi F. , et al. Development and validation of the French version of a tool assessing patient's expectations in lower limb osteoarthritis. J Orthop 2014; 12 (01) 46-57
• 35 Haanstra TM, van den Berg T, Ostelo RW. , et al. Systematic review: do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?. Health Qual Life Outcomes 2012; 10 (01) 152
• 36 Tolk JJ, Haanstra TM, Reijman M. Letter to the editor on “what do Scottish patients expect of their total knee arthroplasty?”. J Arthroplasty 2016; 31 (10) 2374